Mozas-Moreno Juan, Sánchez-Fernández Mariola, González-Mesa Ernesto, Olmedo-Requena Rocío, Amezcua-Prieto Carmen, Jiménez-Moleón José J
Department of Obstetrics and Gynecology, University of Granada, 18016 Granada, Spain.
Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 18014 Granada, Spain.
J Clin Med. 2023 Apr 20;12(8):2995. doi: 10.3390/jcm12082995.
(1) Background: The accuracy of ultrasound estimation of fetal weight (EFW) at term may be useful in addressing obstetric complications since birth weight (BW) is a parameter that represents an important prognostic factor for perinatal and maternal morbidity. (2) Methods: In a retrospective cohort study of 2156 women with a singleton pregnancy, it is verified whether or not perinatal and maternal morbidity differs between extreme BWs estimated at term by ultrasound within the seven days prior to birth with Accurate EFW (difference < 10% between EFW and BW) and those with Non-Accurate EFW (difference ≥ 10% between EFW and BW). (3) Results: Significantly worse perinatal outcomes (according to different variables such as higher rate of arterial pH at birth < 7.20, higher rate of 1-min Apgar < 7, higher rate of 5-min Apgar < 7, higher grade of neonatal resuscitation and need for admission to the neonatal care unit) were found for extreme BW estimated by antepartum ultrasounds with Non-Accurate EFW compared with those with Accurate EFW. This was the case when extreme BWs were compared according to percentile distribution by sex and gestational age following the national reference growth charts (small for gestational age and large for gestational age), and when they were compared according to weight range (low birth weight and high birth weight). (4) Conclusions: Clinicians should make a greater effort when performing EFW by ultrasound at term in cases of suspected extreme fetal weights, and need to take an increasingly prudent approach to its management.
（1）背景：足月时超声估计胎儿体重（EFW）的准确性对于处理产科并发症可能有用，因为出生体重（BW）是一个代表围产期和孕产妇发病率重要预后因素的参数。（2）方法：在一项对2156名单胎妊娠妇女的回顾性队列研究中，验证了在出生前七天内通过超声估计的足月极端BW中，准确EFW（EFW与BW之间差异<10%）和非准确EFW（EFW与BW之间差异≥10%）的围产期和孕产妇发病率是否不同。（3）结果：与准确EFW相比，产前超声估计的非准确EFW的极端BW的围产期结局明显更差（根据不同变量，如出生时动脉血pH<7.20的发生率更高、1分钟阿氏评分<7的发生率更高、5分钟阿氏评分<7的发生率更高、新生儿复苏等级更高以及需要入住新生儿重症监护病房）。当根据国家参考生长图表按性别和孕周的百分位数分布比较极端BW时（小于胎龄和大于胎龄），以及当根据体重范围（低出生体重和高出生体重）进行比较时，情况都是如此。（4）结论：临床医生在足月超声检查怀疑胎儿体重极端的情况下进行EFW时应付出更大努力，并且在管理上需要采取越来越谨慎的方法。
